{
  "abstract": "Objective To assess the association between histological chorioamnionitis without maternal clinical symptoms and neurodevelopmental disabilities at age 5 years in children born very preterm.Design French national prospective population-based cohort study, EPIPAGE-2 ( Etude épidémiologique sur les petits âges gestationnels).Setting All births from 22 to 34 weeks of gestational age in France in 2011 were eligible.Population Infants born alive between 24 +0 and 31+6 weeks following preterm labour (PTL) or preterm premature rupture of membranes (PPROMs).Exposure Histological chorioamnionitis without maternal clinical symptoms, also called isolated histological chorioamnionitis, was defined as the presence of neutrophils in the chorionic plate, excluding clinical chorioamnionitis.Main outcome measures Neurodevelopmental disabilities, a composite outcome including cerebral palsy, developmental coordination disorders, sensory impairment, developmental cognitive deficiencies or behavioural difficulties. These assessments were comprehensive, standardised and conducted by trained neuropsychologists and paediatricians at age 5 years.Results Among 1296 children alive at 5 years of age, 486 (36.3%) were born in a context of isolated histological chorioamnionitis. Overall, 47% vs 33.6% of children exposed and not exposed to isolated histological chorioamnionitis had mild neurodevelopmental disabilities, and 13.8% vs 13.3% had moderate-to-severe neurodevelopmental disabilities. After multiple imputation and multivariable analysis, isolated histological chorioamnionitis was found not to be associated with the occurrence of mild or moderate-to-severe neurodevelopmental disabilities (adjusted OR: 1.0, 95% CI: 0.7 to 1.4 and 0.9, 0.6 to 1.2).Conclusion We did not find any association between isolated histological chorioamnionitis and neurodevelopmental disabilities at age 5 years in children born very preterm after PTL or PPROM.",
  "authors": [
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France",
        "AP-HP, Gynecology and Obstetrics, Robert-Debré Mother-Child University Hospital, Paris, Île-de-France, France"
      ],
      "name": "Fanny Salmon"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France",
        "Department of Neonatal Pediatrics, Armand Trousseau Hospital, Paris Sorbonne University, AP-HP, Paris, Île-de-France, France"
      ],
      "name": "Mathilde Letouzey"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France"
      ],
      "name": "Laetitia Marchand-Martin"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France",
        "Department of Neonatal Pediatrics, Cochin Port Royal Hospital, APHP, Paris, France"
      ],
      "name": "Héloïse Torchin"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France"
      ],
      "name": "Valérie Benhammou"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France"
      ],
      "name": "Kaminski Monique"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France"
      ],
      "name": "Véronique Pierrat"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France",
        "Neonatal Care Unit, Armand-Trousseau Hospital, Paris, Île-de-France, France"
      ],
      "name": "Laurence Foix-L’Helias"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France"
      ],
      "name": "Pierre Yves Ancel"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France",
        "Unit of Population Epidemiology, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, GE, Switzerland"
      ],
      "name": "Elsa Lorthe"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France",
        "Gynecology and Obstetrics, Armand-Trousseau Hospital, Paris, Île-de-France, France"
      ],
      "name": "Gilles Kayem"
    },
    {
      "affiliations": [
        "UMR 1153, CRESS, Obstetric, Perinatal, and Pediatric Life course Epidemiology, OPPaLE Team, INSERM, Paris, France",
        "AP-HP, Gynecology and Obstetrics, Robert-Debré Mother-Child University Hospital, Paris, Île-de-France, France",
        "Department of Neonatal Pediatrics, Armand Trousseau Hospital, Paris Sorbonne University, AP-HP, Paris, Île-de-France, France",
        "Department of Neonatal Pediatrics, Cochin Port Royal Hospital, APHP, Paris, France",
        "Neonatal Care Unit, Armand-Trousseau Hospital, Paris, Île-de-France, France",
        "Unit of Population Epidemiology, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, GE, Switzerland",
        "Gynecology and Obstetrics, Armand-Trousseau Hospital, Paris, Île-de-France, France"
      ],
      "name": "EPIPAGE 2 Study-group"
    },
    {
      "affiliations": [],
      "name": "EPIPAGE-2 Working group on infections"
    }
  ],
  "title": "Histological chorioamnionitis and neurodevelopment at 5 years of age among infants born very preterm: EPIPAGE-2 cohort study",
  "uid": "d572d48c-c349-5750-855a-dd9f55226d57"
}